Key result
Five long-acting α1-blockers (terazosin, doxazosin, tamsulosin, alfuzosin, and silodosin) are effective in relieving LUTS/BPH independent of prostate size, with silodosin showing high selectivity.
Why the study?
Do α1-adrenoceptor blockers relieve symptoms in patients with LUTS/BPH?
Do α1-adrenoceptor blockers relieve symptoms in patients with LUTS/BPH?
α1-Adrenoceptor blockers, including newer agents like silodosin, provide effective relief of LUTS/BPH with varying safety profiles regarding orthostatic hypotension and abnormal ejaculation.
May support α1-blocker use for LUTS/BPH regardless of prostate size; leaves open comparative long-term safety and efficacy.
PURPOSE OF REVIEW: α1-Adrenoceptor blockers are the most frequently prescribed medical therapy in the treatment of lower urinary tract symptom suggestive of benign prostatic hyperplasia (LUTS/BPH). The purpose of this review is to highlight the evolution of adrenoceptor blockers with emphasis on newly approved drugs. RECENT FINDINGS: Over the past years new formulations of several α1-adrenoceptor blockers were introduced to the market. Five long-acting α1-blockers are currently approved by the Food and Drug Administration for treatment of symptomatic LUTS/BPH: terazosin, doxazosin, tamsulosin, alfuzosin and silodosin. Silodosin is the only adrenoceptor blocker that exhibits true selectivity for the α1-adrenoceptor subtypes. This unique adrenoceptor selectivity profile likely accounts for the very favorable cardiovascular safety profile. SUMMARY: Tamsulosin, alfuzosin slow release and silodosin do not require dose titration. Alfuzosin, terazosin, doxazosin and silodosin have all been shown to be effective in relieving LUTS/BPH independent of prostate size. Low incidence of orthostatic hypotension has been reported for silodosin, but abnormal ejaculation is the most commonly reported adverse effect.
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Lepor et al. (2011) conducted a review in Lower urinary tract symptom suggestive of benign prostatic hyperplasia (LUTS/BPH). α1-Adrenoceptor blockers (terazosin, doxazosin, tamsulosin, alfuzosin, silodosin) was evaluated. Five long-acting α1-blockers (terazosin, doxazosin, tamsulosin, alfuzosin, and silodosin) are effective in relieving LUTS/BPH independent of prostate size, with silodosin showing high selectivity.
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